纤维蛋白相关标志物检测在重症肺炎患儿DIC前状态的诊断价值  

Diagnostic value of fibrin-related markers for pre-disseminated intravascular coagulation state in children with severe pneumonia

作　　者：王香英 魏金凤 

机构地区：[1]杭州市儿童医院儿科,浙江省310006

出　　处：《江苏医药》2017年第20期1445-1448,F0003,共5页Jiangsu Medical Journal

基　　金：杭州市卫生科技计划一般项目(2013A52)

摘　　要：目的探讨纤维蛋白单体(FM)、D-二聚体(D-D)、纤维蛋白降解产物(FDP)诊断重症肺炎患儿弥散性血管内凝血(DIC)前状态的价值。方法 104例重症肺炎患儿分为DIC前状态组(48例)和DIC组(56例),另选同期体检的健康儿童40例作为对照组。分别检测和比较三组FM、D-D、FDP、Plt、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(Fib)、血栓调节蛋白(TM)等指标,同时绘制ROC曲线,分析其诊断重症肺炎患儿DIC前状态的价值。结果 DIC前状态组FM、D-D、FDP、PT、APTT、Fib、Plt和TM均高于对照组(P<0.05),DIC组FM、D-D、FDP和TM高于对照组(P<0.05)。FM、FDP和D-D诊断重症肺炎患儿DIC前状态的AUC分别为0.884、0.759和0.750,三者联合诊断时AUC为0.892。结论纤维蛋白相关标志物FM、D-D和FDP可作为重症肺炎患儿DIC前状态有价值的诊断标志物。Objective To explore the significance of fibrin monomer（FM）, D-dimer（D-D） and fibrin degradation products（FDP） in the diagnosis of pre-disseminated intravascular coagulation（pre- DIC） state in the children with severe pneumonia. Methods A total of 104 children with severe pneumonia was divided into two groups of A（with pre-DIC state, 48 cases） and B（with DIC state, 56 cases）. Forty healthy children were taken as the controls（group C）. The levels of FM, D-D, FDP, platelet count（Pit）, fibrinogen （Fib）, thrombomodulin （TM）, prothrombin time （PT） and activated partial thromboplastin time（APTT） were detected. The ROC curves were drawn to compare the value of the indicators in the diagnosis of pre-DIC state. Resdts The levels of FM,D-D,FDP,PT,AP＇I^I＂, Fib,Ph and TM were all higher in group A than those in group C（P〈O. 05）. The levels of FM, D-D, FDP and TM in group B were higher than those in group C（P〈0. 05）. The AUC values of FM,FDP and D-D in diagnosing pre-DIC state in children with severe pneumonia veere 0. 884,0. 759 and 0. 750, respectively. The AUC was 0. 892 when combined detection of FM,D-D and FDP. Conclusion FM, FDP and D-D may be taken as the valuable fibrin-related markers in diagnosing pre-DIC state in children with severe pneumonia.

关 键 词：重症肺炎 弥散性血管内凝血 纤维蛋白单体 D-二聚体 儿童 

分 类 号：R446.1[医药卫生—诊断学]